Hemorrhage arrester



June 27, .1939. R E CORNISH 2,163,588

HEMORRHAGE ARRESTER Filed Nov. 25, 1955 EIEJ. 315-2.

INVENTOR.

ROBERT E. CRN/SH.

Ewa/@JMS ATTORNEY Patented June 27, 1939 UNITED STATES PATENT OFFICE 17 Claims.

My invention relates to wound dressings and more particularly to a composition of matter adapted for use in arresting hemorrhage.

The present application is a continuation in part of my application Serial No. 16,403, filed April 15, 1935, for a Wounding dressing.

' Loss of life resulting from hemorrhage constitutes an ever-present hazard to soldiers and sailors in time of war, to those engaged in dangerous occupations, and in fact to all persons in varying degrees, regardless of occupation. This danger to the common citizen has steadily increased, due in no small measure to the widespread use of the automobile. Unfortunately, most accidents do not happenin front of a doctors oiiice or hospital and first aid must therefore be speedily rendered to the victim by lay comrades, policemen, firemen or chance passersby, but such aid is ordinarily unavailing in case o the hemorrhage occurs in that portion of the Victlms body Where a tourniquet cannot be applied. It is therefore an important object of my invention to provide a wound dressing particularly adapted for emergency use in arresting free bleeding in a wound.

Other objects of my invention are: kto provide a composition/of matter having the ability to accelerate the coagulating rate of blood; to provide a resilient anti-hemorrhage pad capable of retaining its resilience. when subjected to blood fluid; to provide an anti-hemorrhage pad formed `from a .loosely grouped fibrous material having mixed therewith a reinforcing material tending to prevent collapse; to provide a resilient fibrous anti-hemorrhage pad which is substantially impervious to blood fluid when compressed in a wound; to provide a fibrous anti-hemorrhage pad having antiseptic and anaesthetic properties; to provide a hemorrhage arrester adapted to be used as a plug to seal a bleeding wound; and to provide a new and improved wound dressingy capable of being employed by the user with minimum danger of infection.

My invention possesses .numerous other objects and features of advantage, some of which, together with the foregoing, will be set forth in the following description this specification, but I do not limit myself to the embodiment of my invention herein described as Various forms may be adopted within the scope of the claims.

Referring to the drawing: y Figure 1 is a view, greatly magnified, of a fragment of a pad formed from a random interlace of textile fiber.

forming a part of (Cl. 12S-156) Figure 2 is a view, greatly magnified, of a fragment of a pad formed from a random interlace of textile fiber, together with a supporting amount of wool fiber.

Figure 3 is a view of a magnified fragment of a pad formed from a random interlace of uniform fibers, such as shown in Figure 1, but whichv has been treated with a viscous agent.

Figure 4` is a perspective View of my antihemorrhage pad with its protective covering, the covering being shown in opened position.

It has long been known that spider web has the property of arresting hemorrhage. There are, however, a large number of objections to the use of this material in modern medicine. Spider web is not adaptable to be collected in quantities sufficient to ed to widespread use. In its natural state it is known to be greatly contaminated by dirt and especially by bacteria fore can only be used in its natural condition under stress of the greatest emergency. It is also not adaptable to sterilization and does not have suflicient resilience to 'stand up under the pressure which must necessarily be applied in the ordinary methods of dressing a wound.

The action of spider web in accelerating coagulation is due to the fact that the diameter of the web filaments is small and the web when formed into a pad and placed against a bleeding point offers a very large surface of foreign material in contact with the releasedblood. The larger this surface, the greater the coagulating power of the dressing.

Another valuable property of the spider web make surgical pads adapt-- of many types and thereis its stickiness causing the filaments to ad` here to each other, to the wound and to the edge of the bleeding vessel. Furthermore, the sticky substance on the web filaments is 'viscous and substantially non-hardening in character and normally exists insufficient amount to ll the spaces between the filaments when a pad formed thereof is compressed in a wound. Thus such a pad acts as a plug to seal the wound and arrest the flow of blood, whereby a clot can form undisturbed in and around the bleeding vessel. A further property of the sticky, viscous material found on spider web is its non-solubility in blood fluid and, since it fills the capillary spaces in thebers themselves, as well as the interstices in a pad formed thereof, when under compression, resilience is maintained and loss of blood through absorption eliminated. 4

The present invention broadly is directed toward a composition of matter which will give improved results in the arrest of hemorrhage but which is not subject to the disadvantages of the natural material of the spider web.

The examination of a spiderk web under a microscope shows the diameter of the average web lament to be about 7 microns, 1 micron being /ooo of a millimeter, or approximately 1,5500() of an inch. In the descrip-tion which follows, all measurements will be given in microns.

In the practice of my invention I have found that a relatively ne ber, preferably having a diameter of less than microns, is the most satisfactory, particularly when used in the formA of a random interlace or loose grouping instead of in a fabric where the bers have been tightly compacted, united, knitted, woven or otherwise combined.

I also prefer that the brous material possess some degree of natural resiliencein order that when a pad thereof is applied to a wound some of the bers will spring away from the main body of the pad and into the irregular crevices of the wound to form a skeleton net-work therein, thus offering a maximum surface to the blood to promote prompt and rapid coagulation.

In the examination of particular typesof ber adaptable for the practice of my invention I have found that certain bers entering into a fabric known as Bemberg in the trade are particularly satisfactory for arresting hemorrhage. for example, a particular synthetic ber, said to be made by the cuprammonia process from vcotton linters by the stretch Spinning process, has a ber diameter of about '7.5 microns. In this particular case the fibers were obtained from yarn rated at 150 denier, 225 lament, untwisted, and had been cut into four-inch lengths and especially carded by hand to obtain a random interlace in order to better expose the large combined ber surfaces. I find, however, that equally good loosely consolidated ber groups can be made directly from the unspun ber.

There are, however, other fibers available whichare the complete equivalent of the synthetic cellulose bers. Pineapple ber from Ananasa sativa runs between 4 and 8 microns in diameter and can even be made, if desired, as ne as 1 micron in diameter. Again, in winding silk from the cocoons, there is'often a finer silk at one or both ends of the filament, which is often discarded as unsuitable for textiles because ofexcessive neness. 'Ihese out ends may be collected and used and are, in the cocoon winding locations, present in suicient quantity to be used commercially. I, therefore, do not wish to be limited to any particular ber, except that it shall be relatively ne and have suicient resilience to resist substantial compaction when used in the form of a pad as a wound dressing.

A fragment of a pad composed of relatively uniform cellulose bers is shown in Figure 1. It is, of course, understood that the assembled pads of cellulose ber are readily adaptable for sterilization and such treatment does not appear to destroy the natural resilience o f the ber.

While the homogeneous pads formed from bers all of the same type such as I have above described possess a certain amount of flexibility, I have found that it is of considerable advantage to incorporate into the brous mass other components which will aid and still further increase the flexibility of the pad. For example, I have found that wool bers possess the remarkable property of maintaining practically all of their resilience when wet with water, blood or viscous adhesives, and it is obvious that ne metallic threads or excelsior of non-corrosive material will act in a similar manner. If, therefore, a certain percentage of wool or metallic ber be mixed with the finer cellulose bers, greater resilience and flexibility is given to the pad. A pad of this character when applied to a wound by pressure will be intimately compressed throughout its main body, but into the irregular crevices of the wound there will spring out a nemesh net-work of bers completely interlacing any air spaces, blood or fluid material therein.

The Wool and metallic ber is generally larger than the fine bers previously described and is, therefore, stronger, wool often ranging from 15 to microns in diameter.` My invention, therefore, also includes the combination of wool, metallic or other highly resilient fiber with the small diameter bers. However, wool alone may be satisfactory if provided with a certain amount of viscous material whereby the bers will stick together in a loose grouping with the spaces between the bers occupied by such material when the pad is under the pressure of application. A magnied fragment of a pad comprising a mixture of the larger wool or metallic bers and the ner bers is shown in Figure 2.

It is well known that in the usual hemorrhage case death does not ordinarily result at once from loss of blood but rather the loss ofl blood so weakens the victim that he is unable to rally from his other injuries. It is, therefore, important that an anti-hemorrhage pad to be fully effective must arrest 'the flow of blood instantly upon application to the wound. I have found that pads formed of brous materials which are absorptive of blood uid, are unsatisfactory, for not only is there loss of blood through absorption but as the bers become wet they lose resilience and tend to compact, thereby creating open spaces which permit recurrence of free bleeding.

In my anti-hemorrhage pad I have eliminated the defects created by absorption and compaction by applying a viscous or sticky agent to the bers. I prefer that this viscous agent be relatively soft and substantially non-hardening in character; that it be substantially insoluble in aqueous solutions in order that the bers, when impregnated or coated thereby, will be rendered substantially non-absorptive of blood uid; and also that it be of such character that it will not melt and run o the fibers when subjected tothe temperatures necessary for sterilization or as may be found in hot climates. I may use various thick viscous oils or greases such as a combination of resin plus castor oil, aluminum stearate plus olive or mineral oil, petroleum jelly of petrolatum'type or rezyl balsam, which latter has a resin base of the saturated alkyd type, that is, a' compound of phthalic, or other polybasic acid with glycerin or other polyhydric alcohol, and this base is chemically modified with non-drying fatty acids. However, other viscous agents, relatively non-destructive to living tissue and which will not substantially interfere with the normal resilience of the pad, will readily suggest themselves to those skilled in the art.

I prefer to apply the viscous agent to the bers in such manner as to leavev a substantial coating thereon so that when the pad ls applied to a wound under pressure the viscous agent will be actuated to ll the interstices in the pad, whereby the pad forms a blood impervious plug which seals the wound instantaneously and permits the blood fluid to coagulate in and around the severed vessel. It is to be noted that such a pad will retain its flexibility and effectiveness during use. Furthermore, it can be readily withdrawn from the wound without undue disturbance of the wounded surfaces, since it does not compact or become stiff or hard through absorption of blood uid. I have shown in ligure -3 a fragment of a pad of substantially uniform bers 2 such as shown in Figure ,1, to which a viscous agent 3 hasbeen applied', and it is to be understood that the'viscous agent will be applied in the same manner to a pad of the mixed fibers illustrated in Figure 2.

My invention contemplates certain other modications and features of advantage. Forinstance, I` may incorporate a stypticmaterial with the JMviscous agent in order to enhance coagulation of the blood fluid. I prefer that the styptic material be soluble in oil so that it can he readily incorporated with the viscous agent.A In this connection I have found that the oils of bergamot, lemon, erigeron or clove are very satisfactory; however, I do not wish to be limited to any particular type of material since there are many other well known styptics which will readily suggest themselves to those skilled in the art. It is to be understood that I do not intend to exclude from my invention the use of styptics that are insoluble in oil for such styptics are efllcacious if applied as a coating on the viscous agent.

In addition to the styptic, I prefer that my pad possess antiseptic properties, since it will ordinarily be left in,a wound for a considerable length of time and because wounds inflicted on the battle field or resulting from accident are apt to be impregnated with dirt and other foreign matter highly potent with harmful bacteria. 'While I prefer to use the less volatile antiseptics' such as benzoin, phenyl salicylate, or naphthoi, and to employ the viscous agent as a vehicle for carrying the same, there are numerous other well known antisepticsl which are entirely satisfactory and these will readily suggest themselves to those skilled in the art. It is-to be understood, however, that volatile antiseptics may be used and that ing to the viscous agent instead of intermixed therewith, allwithout departing from the spirit oi.' my invention.

To be fully effective, my anti-hemofrhage pad must be applied under considerable pressure and, in case of a serious wound which is itself inherently painful, such treatment is apt to be unbearable, particularly whenthe application extends over a considerable period of time. Under such circumstances the pain is apt to cause the patient to squirm and twist around, making it extremely difficult for the one applying the pad to maintain it in position as an effective seal or plug. I, therefore, contemplate the inclusion of an agent capable of acting as a local anaesthetlc. For example, I may use ethyl-para-amino benzoate or butyl-para-amino benzoate, but, of course, I do not desire to be limited to any particular anaesthetic agent, since a wide variety of satisfactory anaesthetics will suggest themselves to those versed in the art.

With reference to both antiseptic and anaesthetic agents, I prefer that they be relatively nonvolatile, to be soluble in fatty or resinous material, and to be relatively non-oxidizing on fatty oils or organic matter, also to be not readily hydrolyzed or decomposed by contact with aqueous substances. The anaesthetic agent, like the antiseptic and styptic, can be either intermixed with Athe viscous agent or applied as a coating thereon.

the antiseptic may be applied as a coat- While I vhave referred to certain agents as styptic, anaesthetic or antiseptic, it is toA be understood that one or more of such properties may reside in a single agent. For instance, oil of clove not only possesses styptic properties but also anaesthetic properties. My invention, therefore, may include the use of a single agent possessing one or more of such properties.

In addition to the foregoing modifications of my invention, I have found it desirable to back my pad with a thin sheet of rubber or some tightly-woven fabricl which is substantially impervious to aqueous solutions including blood fluid. This backing, it is to be noted, will serve to keep the hands of the u ser out of direct contact with the pad itself, thus minimizing the danger of contamination and infection. Also, such a backing facilitates the handling of the pad and provides a sanitary covering within which the fibrous mass can be enfolded and protected when not in use.

pad provided with such a backingv is illustrated in Figure 4. Here, the pad 4 of fibrous material is suitably secured to the backing sheet 5 by means of a thread 6. The thread may overloop the entire pad or it may be threaded through only a portion thereof, or the pad may be cemented or otherwise secured to the sheet.

Experiments have been made upon sheep and it `was found that if the jugular vein and carotid artery on one side of a sheeps neck were both cut to give a complete severing of both vessels, it was not possible to permanently arrest hemorrhage by the application to the wound of the ordinary cotton batting, as bleeding continued directly through the batting. Pads made according to the present invention however,applied in the Same position and with the same pressure, generally arrested bleeding almost immediately and after being in place -solidied the clot to such an extent that hemorrhage was completely stopped.

It is apparent from the foregoing that my invention as an article of manufacture is particularly adaptable for emergency use in the arrest of hemorrhage. Its antiseptic and anaesthetic properties make it an ideal dressing for serious and painful wounds such as are likely to occur in automobile accidents'and on the battle field, and it is so protected that it can be readily and speedily used without danger of contamination from-the unclean hands of the user.

The terms petroleum grease and petroleum base grease are used herein to refer in the first instance to a grease in which hydrocarbons derived from petroleum constitute a major portion of the ingredients and in the second instance, to a grease in which hydrocarbons derived from petroleum constitute a substantial or important part of the ingredients. In using these definitions Iam familiar with the fact that petroleum greases have been otherwise classified for convenience; for example, E. N. Klemgard, in Lubricating Greases, Chemical Catalog Co., New York, 1927, has classified many petroleum greases containing soap according to the metallic constituent of the soap, thus, soda base grease, lime base grease, aluminum base grease, etre. The term water insoluble as used herein refers to the property of the material so described as having only minute solubility in Water, it being generally recognized that the constituent termed insoluble may, and in most cases does, have some slight solubility. Also in the present case, some of the constituents present in the grease or oleaginous agent in minor proportions may have quite appreciable solubility in water.

I claim: 1. A hemorrhage arrester adapted to be pressed into an open bleeding wound for stopping the flow of blood and comprising, a soft resilient compressible porous body of blood repellant ma terial being self retaining and resilient when subjected to blood, and a water insoluble viscous grease carried by said body in a proportion effective to substantially fill the pores of said body on compression thereof into a wound at normal applying pressures to provide a substantially blood impervious plug in the wound.

2. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the flow of blood and comprising, a soft resilient compressible porous body of fine fibers of a blood resistant material, and a water insoluble viscous grease carried by said body in a proportion effective to substantially fill the space between Said fibers upon application of the body into a wound at normal apply pressures.

3. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the flow of blood and comprising, a soft resilient compressible porous body of fine fibers of a blood resistant material capable of retaining its resiliency when wetted by blood, a water insoluble viscous grease carried by said body in a proportion effective to substantially fill the space between said bers upon compression of the body into a wound, and a blood and grease impervious member attached to said body for facilitating manual compression of the body into an open bleeding wound.

4. A hemorrhage arrester adapted to be pressed into an open bleeding Wound for stopping the flow of blood and comprising, a soft resilient compressible porous body of blood resistant material capable of retaining a Substantial amount of its resilience when wetted with blood and effective when compressed into a Wound to resiliently expand into substantially all portions of the wound, a viscous petroleum grease carried in the pores of said body and effective on compression of said body to substantially impede the flow of blood and to facilitate removal of the body from the wound after clotting of the`blood, and an oil soluble styptic `material carried by said grease. I

5. A hemorrhage arrester adapted to be pressed into an open bleeding wound for stopping the flow of blood and comprising, a soft resilient compressib.e porous body of blood resistant material capable of retaining a substantial amount of its resilience when wetted with blood and effective when compressed into a Wound to resilient- 1y expand into substantially all portions of the wound, a viscous petroleum grease carried in the pores of said bodyand effective on compression of said body to substantially impede the flow of blood and to facilitate removal of the body from the wound after clotting of the blood, and an oil soluble antiseptic material carried by said grease.

6. A hemorrhage arrester adapted to be pressed into an open bleeding wound for stopping the iiow of blood and comprising, a soft lresilient compressible porous body of blood resistant material capable of retaining a substantial amount of its resilience when wetted with blood and effective when compressed into a Wound to resiliently expand into substantially all portions of the Wound, a viscous petroleum grease carried in the pores of said body and effective on compression of said body to substantially impede thel iiow of blood and to facilitate removal of the Ibody from the wound after clotting of the blood, and an oil soluble anaesthetic material carried by said grease.

7. A hemorrhage arrester comprising, a soft compressible resilient porous body, and water insoluble oleaginous agents added to said body in proportion less than saturation but such that when said body is compressed against a bleeding wound at normal applying pressures said agent will substantially ll the pores of said body.

8. A hemorrhage arrester adapted to be pressed into an open bleeding Wound for arresting the flow of blood and comprising, a soft resilient compressible porous body, and a petroleum base .grease in said body for rendering the same substantially blood impervious upon compression into a bleeding wound.

9. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the flow of blood and comprising, a soft resilient compressible Aporous body of fine fibres of blood resistant material, and a petroleum base grease in said body for rendering the same substantially blood impervious upon compression into a bleeding Wound.

10. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the flow of blood comprising, a soft resilient compressible porous body of wool fibres having an average'diameter up to approximately 15 microns, and a petroleum base grease in said body for rendering the same substantially blood impervious upon compression into a bleeding wound.

11. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the ow of blood comprising, a soft resilient compressible porous body of wool fibres having an average diameter up to approximately 15 microns, and a petroleum base grease added to said body in proportion less than saturation but such that when said body is compressed against a bleeding `wound at normal applying pressures said grease will substantially fill the pores o' said body.

12. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arrestingthe iiow ofblood comprising, a soft resilient compressible-porous body of Wool fibres having an average diameter up to approximately 15 microns, and a petroleum base grease added to said body in proportion less than saturation but such that when said body is compressed against a bleeding Wound at normal applying pressures said grease will substantially fill the pores of said body, said grease being soft and plastic at normal atmospheric temperatures and retaining its plasticity at sterilizing temperatures to enable sterilization of said body and grease without running oi of said grease.

13. A hemorrhage arrester adapted to be pressed into an open bleeding wound for arresting the flow of blood comprising, a soft resilient compressible porous body of blood repellent man terial form-retaining when subjected to blood, and a water insoluble oleaginous grease in said body for increasing its resistance to absorption of blood when compressed in a Wound at normal applying pressures, said grease being soft and plastic at ordinary atmospheric temperatures and retaining its plasticity at sterilizing temperatures whereby said grease will not run off of said body when sterilized.

14. A wound dressing adapted to be pressed into an open bleeding wound for arresting the flow of blood comprising, a soft resilient comv pressible porous body of blood repellent material form-retaining when subjected to blood, and a Water-insoluble viscous oil carried by said body and partially filling the pores thereof and effective on compression of said body into a wound to impede the ow of blood into said body.

15. A wound dressing adapted to be pressed into an open bleeding Wound for arresting the flow of blood comprising, a soft resilient compressible porous body of fine fibers of blood repellent material form-retaining when subjected to blood, and a Water-insoluble viscous oil carried by said body and partially lling the pores thereof and eiective on compression of said body into a Wound to impede the flow of blood into said body.

16. A wound dressing adapted to be pressed into an open bleeding wound for arresting the flow of blood comprising, a soft resilient compressible porous body of ne wool bers of average diameter up to about 15 microns, and a Water-insoluble viscous oil carried by said body and partially lling the pores thereof and effective on compression of said body into a wound to impede the flow of blood into said body.

17. A wound dressing adapted to be pressed into an open bleeding Wound for arresting the ilcw of blood comprising, a soft resilient compressible pad of pineapple ber impregnated with an oleaginous agent in a loosely grouped form. 

